Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and...Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and 2 investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances. Design:Clinical study. Setting:University hospital. Patient(s):Twenty-eight obese and overweight (body mass index BMI > 25 kg/m2) women with PCOS,28 normal weight (BMI < 25 kg/m2) women with the syndrome,and 13 obese and overweight controls (ovulatory women without clinical or biochemical hyperandrogenemia)-were selected. Intervention(s):Blood samples were collected between day 3 and day 6 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls,at 9:00 AM,after an overnight fast. Main Outcome Measure(s):Circulating levels of LH,FSH,PRL,T,Δ4-androstenedione (A),DHEAS,17α-OH-P,sex hormone-binding globulin (SHBG),insulin,glucose,and metastin were measured. Result(s):Both normal weight women with PCOS and obese controls were less insulin resistant and had significantly higher metastin levels,compared to obese and overweight women with the syndrome. Plasma kisspeptin levels were negatively correlated with BMI,free androgen index,and indices of insulin resistance. Conclusion(s):These results indicate that metastin is negatively associated with free androgen levels. The PCOS-associated insulin resistance and consequent hyperinsulinemia probably contribute to this effect by 1 stimulating androgen synthesis by the polycystic ovary (PCO) and 2 suppressing SHBG production in the liver.展开更多
Objective: Although evidence on elevated creatine phosphokinase (CPK) as a tool for the diagnosis of ectopic pregnancy (EP) is rather conflictive, no previous study on CPK isoenzyme levels and their relative ratio was...Objective: Although evidence on elevated creatine phosphokinase (CPK) as a tool for the diagnosis of ectopic pregnancy (EP) is rather conflictive, no previous study on CPK isoenzyme levels and their relative ratio was found in the literature. Study design: Forty women with EP, 20 with intrauterine (IU) abortive gestation, and 20 regular pregnant women (controls) were studied. Serum total CPK, CPK-MB, and CPK-MM levels were measured at the time of presentation and 24 hours after surgery. Relative operating characteristic (ROC) curves were plotted. Results: Women with EP had significantly higher CPK concentrations and a significantly decreased CPK-MB relative ratio (CPK-MB%), compared with both women with IU abortive pregnancy and controls. The ROC curves demonstrated a significant discriminatory ability of both increased total CPK and decreased CPK-MB%ratio for the diagnosis of EP. Conclusion: Determination of CPK isoenzyme fractions can significantly enhance the diagnostic value of total maternal CPK in the prediction of ectopic pregnancy.展开更多
Background: The study aim was to investigate the relationship between insulin resistance(IR), β-cell function(βF), hyperandrogenism and proinsulin levels during an oral glucose tolerance test(OGTT) in women with pol...Background: The study aim was to investigate the relationship between insulin resistance(IR), β-cell function(βF), hyperandrogenism and proinsulin levels during an oral glucose tolerance test(OGTT) in women with polycystic ovary syndrome(PCOS). Methods: One hundred and twenty-six selected women were classified as follows: PCOS, BMI >25 kg/m2(n=39); PCOS, BMI< 25 kg/m2(n=54); controls, BMI >25 kg/m2(n=14); controls, BMI< 25 kg/m2(n=19). Blood samples were collected between the third and sixth day of a spontaneous menstrual cycle, at 9:00 a.m., after an overnight fast. Serum levels of FSH, LH, PRL, 17α-OH-progesterone, SHBG, testosterone, Δ4-androstenedione, insulin, proinsulin and glucose were measured. A 75 g OGTT was performed, and concentrations of glucose, insulin and proinsulin were also measured at t=30, 60, 90, and 120 min. Results: The markers of insulin secretion and the AUC for proinsulin were higher in obese and overweight women and in women with PCOS, respectively. The AUC for proinsulin was positively correlated with markers of IR, βF and androgen levels. An inverse relationship between PI/I values and indices of IR and βF was observed. Conclusions: Increased proinsulin levels reflect, most probably, insulin resistance, which is the key disorder in PCOS-associated metabolic abnormalities. β-Cell function, pre-proinsulin mRNA processing and proinsulin conversion to insulin could be initially increased as a result of IR. An interaction between circulating proinsulin and androgen biosynthesis or action might also exist.展开更多
文摘Objective:This study was designed to:1 measure,for the first time,metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS),a condition associated with hypersecretion of LH and hyperandrogenemia; and 2 investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances. Design:Clinical study. Setting:University hospital. Patient(s):Twenty-eight obese and overweight (body mass index BMI > 25 kg/m2) women with PCOS,28 normal weight (BMI < 25 kg/m2) women with the syndrome,and 13 obese and overweight controls (ovulatory women without clinical or biochemical hyperandrogenemia)-were selected. Intervention(s):Blood samples were collected between day 3 and day 6 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls,at 9:00 AM,after an overnight fast. Main Outcome Measure(s):Circulating levels of LH,FSH,PRL,T,Δ4-androstenedione (A),DHEAS,17α-OH-P,sex hormone-binding globulin (SHBG),insulin,glucose,and metastin were measured. Result(s):Both normal weight women with PCOS and obese controls were less insulin resistant and had significantly higher metastin levels,compared to obese and overweight women with the syndrome. Plasma kisspeptin levels were negatively correlated with BMI,free androgen index,and indices of insulin resistance. Conclusion(s):These results indicate that metastin is negatively associated with free androgen levels. The PCOS-associated insulin resistance and consequent hyperinsulinemia probably contribute to this effect by 1 stimulating androgen synthesis by the polycystic ovary (PCO) and 2 suppressing SHBG production in the liver.
文摘Objective: Although evidence on elevated creatine phosphokinase (CPK) as a tool for the diagnosis of ectopic pregnancy (EP) is rather conflictive, no previous study on CPK isoenzyme levels and their relative ratio was found in the literature. Study design: Forty women with EP, 20 with intrauterine (IU) abortive gestation, and 20 regular pregnant women (controls) were studied. Serum total CPK, CPK-MB, and CPK-MM levels were measured at the time of presentation and 24 hours after surgery. Relative operating characteristic (ROC) curves were plotted. Results: Women with EP had significantly higher CPK concentrations and a significantly decreased CPK-MB relative ratio (CPK-MB%), compared with both women with IU abortive pregnancy and controls. The ROC curves demonstrated a significant discriminatory ability of both increased total CPK and decreased CPK-MB%ratio for the diagnosis of EP. Conclusion: Determination of CPK isoenzyme fractions can significantly enhance the diagnostic value of total maternal CPK in the prediction of ectopic pregnancy.
文摘Background: The study aim was to investigate the relationship between insulin resistance(IR), β-cell function(βF), hyperandrogenism and proinsulin levels during an oral glucose tolerance test(OGTT) in women with polycystic ovary syndrome(PCOS). Methods: One hundred and twenty-six selected women were classified as follows: PCOS, BMI >25 kg/m2(n=39); PCOS, BMI< 25 kg/m2(n=54); controls, BMI >25 kg/m2(n=14); controls, BMI< 25 kg/m2(n=19). Blood samples were collected between the third and sixth day of a spontaneous menstrual cycle, at 9:00 a.m., after an overnight fast. Serum levels of FSH, LH, PRL, 17α-OH-progesterone, SHBG, testosterone, Δ4-androstenedione, insulin, proinsulin and glucose were measured. A 75 g OGTT was performed, and concentrations of glucose, insulin and proinsulin were also measured at t=30, 60, 90, and 120 min. Results: The markers of insulin secretion and the AUC for proinsulin were higher in obese and overweight women and in women with PCOS, respectively. The AUC for proinsulin was positively correlated with markers of IR, βF and androgen levels. An inverse relationship between PI/I values and indices of IR and βF was observed. Conclusions: Increased proinsulin levels reflect, most probably, insulin resistance, which is the key disorder in PCOS-associated metabolic abnormalities. β-Cell function, pre-proinsulin mRNA processing and proinsulin conversion to insulin could be initially increased as a result of IR. An interaction between circulating proinsulin and androgen biosynthesis or action might also exist.
